【摘要】 目的 探究空气污染物长期暴露与4～7岁儿童行为问题的关联。方法 采用横断面研究设计，调查了2303名4～7岁儿童，采用儿童行为量表（children behavior checklist, CBCL）评估儿童行为问题，采用克里金插值法估计个体6种空气污染物(SO₂、NO₂、CO、O₃、PM_2.5和PM₁₀)平均暴露水平，测量时间为自CBCL测量当日起向前推算1年。采用限制性立方样条回归探究污染物与行为问题的非线性关联，并利用混合线性模型探究二者之间的线性关联，敏感性分析则采用二元Logistic回归。结果 NO₂、CO、PM_2.5以及PM₁₀均与内化维度T分呈非线性关联(P_nonlinear<0.05),而SO₂、O₃与内化维度T分、6种污染物与外化维度以及总问题T分均呈线性关联(P_nonlinear>0.05)。线性关联结果中SO₂与内化维度T分呈显著的正向关联[β=1.14（95%CI:0.39,1.89）]。此外，CO每增加1 mg/m³,外化维度T分和总问题T分分别增加1.01（95%CI:0.40,1.62）和1.25（95%CI:0.63,1.86）;PM_2.5每增加1μg/m³,外化维度T分和总问题T分分别增加0.34（95%CI:0.17,0.52）和0.49（95%CI:0.31,0.67）;PM₁₀每增加1μg/m³,外化维度T分和总问题T分分别增加0.38（95%CI:0.05,0.69）和0.51（95%CI:0.18,0.83）。性别亚组分析以及交互作用分析显示，与女童相比，男童长期暴露于CO、PM_2.5和PM₁₀,总问题T分增幅更大(P_交互<0.05);男童长期暴露于NO₂,外化维度T分增幅要高于女童(P_交互<0.05)。敏感性分析结果与该研究主体分析结果基本一致。结论 空气污染物暴露与儿童行为问题得分升高有关，长期暴露于CO、PM_2.5和PM₁₀可能会增加4～7岁儿童行为问题的潜在风险。此外，空气污染物长期暴露对男童行为问题的影响要大于女童。更多还原

【Abstract】 Objective To explore the association between long-term exposure to air pollutants and behavioral problems in children aged 4 to 7 years.Methods A cross-sectional study was designed to investigate 2303 children aged 4 to 7 years.The children’s behavioral problems were assessed with the children behavior checklist（CBCL）.Ordinary Kriging interpolation was used to estimate the average exposure levels of six kinds of air pollutants.The six pollutants were SO₂、NO₂、CO、O₃、PM_2.5 and PM₁₀.The measurement time was calculated from one year prior to the CBCL measurement date.The nonlinear association between air pollutants and behavioral problems was explored by using restricted cubic spline regression, and the linear association between them was explored by using a mixed linear model.For sensitivity analysis, binomial logistic regression was used to explore the relationship between air pollutants and children’s behavior.Results NO₂,CO,PM_2.5, and PM₁₀ were nonlinearly associated with the internalizing T-score(P_nonlinear<0.05),while SO₂,O₃ were linearly associated with internalizing T-score and six pollutants were linearly associated with externalizing and total T-score(P_nonlinear>0.05).The results of linear association showed that SO₂ was significantly positively associated with the internalizing T-score[β=1.14（95%CI:0.39,1.89）].In addition, while CO increased by 1 mg/m³,externalizing and total T-score increased by 1.01（95%CI:0.40,1.62）and 1.25（95%CI:0.63,1.86）,respectively.While PM_2.5 increased by 1 μg/m³,the externalizing T-score and total T-score increased by 0.34（95%CI:0.17,0.52）,and 0.49（95%CI:0.31,0.67）,respectively.Similarly, 1 μg/m³ increment of PM₁₀ was associated with the externalizing T-score[β=0.38（95%CI:0.05,0.69）]and total T-score[β=0.51（95%CI:0.18,0.83）].Gender subgroup and interaction analysis showed that compared with girls, boys with long-term exposure to CO,PM_2.5, and PM₁₀ had a greater T-score increase in total problems(P_interaction<0.05),and boys with long-term exposure to NO₂ had a greater increase in externalizing T-score(P_interaction<0.05).Conclusion Exposure to air pollutants is associated with increased scores for behavioral problems in children.Long-term exposure to CO,PM_2.5,and PM₁₀ may increase the potential risk of behavioral problems in children aged 4-7 years.In addition, long-term exposure to air pollutants has a greater impact on boys than girls in terms of behavioral problems.更多还原